The content of Dark Areas includes topics and subject matter that may not be suitable for all audiences. The views and opinions expressed in this podcast are solely those of the individuals participating in the podcast and do not represent those of AudioChuck or its employees. Information discussed by the host and interviewees includes content related to crimes against children, abuse, acts of terrorism, and violence. Listener discretion is advised. To define something means that you're stating or setting forth the essence of or identifying the nature of something. Put simply, you're reasonably determining fact, specific fact. When it comes to our bodies, there is one very obvious fact that supersedes all others. We're either alive or we're dead. It's medical examiners and coroners across the world's job to figure out specific details that pertain to the latter, death, disease. Most notably, the manner and cause of death, the way in which a person went from being alive to being dead. The profession of a forensic pathologist is often considered somewhat macabre by the general public. But as you'll learn in this episode of Dark Areas, a lot of what these professionals do with death sheds a tremendous amount of light and hope into the realm of the living.

I feel like I'm dying. That was the thought pulsating through my mind as I leaned my rental car driver's seat back to take a nap. I was parked in a parallel space across the street from the Montgomery County coroner's office in downtown Dayton, Ohio. I wasn't really dying, but I was sleep-deprived, hungry, 30 minutes early to the interview, and I was also several weeks pregnant and didn't know it. So yeah, I felt like I was dying. After a quick cat nap, I sprung into journalist mode, crossed the street, and made my way inside the brick building, which looked like every other county office building I've ever been in or seen. Pasted in the windows were signs about masking up and checking in with the receptionist via an electronic doorbell before entering. Inside, past several walls displaying pictures of internal organs, brains, bones, and odd projectiles recovered from people's bodies, Dr. Kent Hershbarger was waiting for me in a conference room. Kent has been the elected Montgomery County coroner in this district of Ohio since 2011. During the last decade, he's been very busy.

We do about 2,400 autopsies a year, about 3 or four hundred external exams. The county that we're in is about 500,000 people. But that caseload is similar to what a million and a half jurisdiction would do. So we're covering about two-fifths the population of Ohio, but about half the geography of Ohio.

According to the US Census Bureau, that's about 20,400 square miles. A lot of space with a lot of people. I'd gotten the chance to look over Kent's credentials before our interview, and I picked up on the fact that he's got quite the resume. For starters, he's a medical doctor, and on top of that, he's also a lawyer. He's also earned a master's degree in Business Administration, a true triple threat.

My background, I was growing up as a lot of young boys do. I wanted to be an Illinois State trooper growing up, so I had a a law enforcement desire, service mentality growing up. And then I joined the army, the National Guard, and I became a combat medic for a while. And so my mom is a nurse. She's a nurse in the and pushed me when I started College of Administration and justice to also do premed.

In case you missed it, he said, combat medic. So add veteran to his resume while we're at it. The way Kent puts it, he didn't settle for pursuing forensic pathology as fate would have it. One day, he just serendipitously found his purpose.

I started working part-time at a hospital, and I just found autopsy pathology just a coincidence. The doctor at the local hospital needed an assistant, so I started helping. And then I started realizing that this field bridged the gap between a law enforcement concept, service mentality to what my mother wanted me to do, which is medicine and science. I found it accidentally, but it's really what I was looking for as a role becoming a service professional.

Something I wanted to get to clarify right off the bat was the difference between a medical examiner and a coroner. I feel like in true crime, you hear those terms used interchangeably a lot like they're the same thing, but depending on what state or even country that you're in, Kent says the roles are actually two very different things.

There's one major difference and big difference in the systems is the coroners are typically elected officials. So the only people the coroners answer to is the voting party, whatever jurisdiction they're in. A medical examiner system usually falls under some administrative authority, state police, public health, those big entities. And the medical examiner system is typically run by a medical professional, a forensic pathologist, where a corner system, because they're elected, can be basically 18-year-old in most states, 18-year-old non-felon and can run for election, which creates some uniqueness to the system where corner is some referred to as a lay corner.

So yeah, in some states and counties, the corner can literally be anyone who wins that elected office and hopefully has a general interest and background in pathology. But that's not a requirement. A medical examiner is a physician or a forensic pathologist who can either be appointed or elected depending on where you live. Kent is actually a hybrid of both.

Ohio is very unique where I am. It is an elected corner system, but they require the corner to be a physician. So it's a medical doctor, a Dr. Madio physician has to run, which merges the two concepts. What I think the public doesn't understand is I sit at the table with the same authority to argue for my piece of the county's budget. So if I'm appointed under somebody as a medical examiner, I'll be holding on them for whatever money and budget resources I get. But as a corner, as elected person, other elected officials at the county table have the same authority and background to argue for my piece of the pie. So it gives me a little, I feel I have a little more freedom, a little more, I don't know, authority is not the right word, but a little more muscle to argue with the people that finance my office versus the medical examiner system where you really are subject to the political whims above you, because you're basically a hired person. Whereas the corner, I get hired every four years.

He says the big reason why some US states like Ohio haven't fully adopted a medical examiner system across all counties comes down to cash.

Medical examiner systems are very expensive. So typically corner systems have evolved and stayed in a much more rural environment because they can run more efficiently. Right now, everything the corner do costs them something. So they're making medical decisions on whether, say, I'm going to do an autopsy or not as a cost point, and we're trying to get rid of that.

So there are times where you, not maybe you personally, but where a coroner system would say, Hey, we don't have the funds to do this type of autopsy or this many. Can they then laterally transfer them to an ME's office and say, Can we outsource the case, essentially?

Exactly. When you don't have enough resources, you have to make decisions somewhere, but it's not ideal. And so if we can remove the cost or put the cost into a bigger pile like the state, then I think it'd be better.

Would you say it's pretty evenly spread? Or would you say that it's way more corners, way more medical.

Examiners thing? Way more medical examiners. The trend is to go to medical examiner systems over time. And that's why I think the corner states that are still present are more rural just because it's too costly to build a medical examiner system to cover a huge jurisdiction like a state.

Fighting for funds and maintaining relationships as an elected official is what takes up a lot of Kent's time nowadays, but he still does autopsies if he needs to. He has staff members who help him with most of the cases that come through his office. But in the event he does want to conduct a procedure himself, he says it all comes down to motor memory.

It gets routine after a while because the procedures we do have been around for 200 years. I mean, the autopsy is the same way. We've added some interesting technology, postmortem CT scans, better radio X-ray equipment. But the actual procedure is done similar to any surgery. The remains are examined head to toe for any disease process, any evidence of trauma visually. The autopsy, because it's a legal also documentation purpose, it's documented photographically. There's records for someone to evaluate, as we talked about, to critique me. The pictures are done. Then the exam continues internally with the typical what's called the Y-shaped incision. It's really a shoulder to shoulder down past the belly button incision that allows us access into all the internal organs. They're examined. An excision is made in the scalp from ear to ear, basically. So the scalp can be removed from the skull, but in such a way that it can be replaced so their funerals can happen without any disruption. The dissection process is usually an hour, could be an hour and a half, two hours. But the real case, putting from information to putting it all together in a package or in a conclusion usually takes three or four weeks to get all the testing back done.

It's a medical process. Procedures are done just the same as any really clinical procedure, head to toe examination of the body.

Naturally, I wanted to know about his very first autopsy. When was the first time for you where you were with a dead body and you realize this is dark, but I have a job to do.

I remember it vividly. I was, as I said, working in a hospital, and I began working in the hospital laboratory, drawing blood, and the pathologist needed autopsy assistant. In my first case, it's grained in there. I don't know really why it happened, but I'm helping her with the dissection of the body. As we do in any autopsy, examine the skull. Part of that is you have to open the scalp in a particular manner. I am doing that, and the eyes opened. It was traumatic as a first experience. I have been around a dead body before then, but to be manipulating or examining in that intimate fashion changed the perspective. But I enjoyed it. I enjoyed the science of it. I'm able to compartmentalize it, I guess. But when the eyes, it's just the drying phenomenon. But when a body that's not supposed to move moves, I still remember it like it just happened.

Kent, like every other pathologist out there, would be lying if he said he had a distinct memory like that of every case he's ever worked. There's unfortunately too many to count. He's seen it all.

When you're at a car crash and there's a death, there's usually from skydiving incidents, trying to get very low before they open the shoot and they had a failure in the opioid crisis. It really was the hard part of it all dealing with the scenes that we go to with babies and cases where there has been a homicide or murder and there's been obvious, yet a sense of the fear and pain that was going on. It's similar to what we're going to get into, I think.

Every case is different for sure. But logistically, the way Kent works them all, well, that pretty much doesn't change.

The case from the forensic pathology perspective is the same. It becomes human anatomy. It becomes a scientific exercise.

There are times, though, when the weight of the job does get heavy to bear.

It is macabre and different. I've had people told me it's my gift because it doesn't… I'm able to compartmentalize it, as many professionals in the field have to be able to do. But I do cry at strange things. My daughter makes fun of me because I'll cry at commercials and but I don't cry in other aspects.

What is the darkest scene that you have been to?

It's probably changed over my career, and the main change is having my own children. So children cases, particularly abused children, really become heavy and hard to bear. One thing you learn to appreciate very quickly is how fragile life is.

I asked Kent to share a specific memory about when he first realized the fragility he's talking about. I knew a lot of his cases tended to blur together, but I was hoping there was one that really stood out. It turns out there was.

My most vivid memory of things that's challenging to deal with is as it goes back to the military, but it's 2003, 2004 time frame. It's at Dover Air Force Base, where the port, March where it is. And all the service members that return are respectfully treated, but they are uniform and cascaded at Dover Air Force Base. So when they return to their families, they're in full uniform, either able to be shown in a typical visitation funeral, or the body is covered and the uniforms just displayed. But I remember vividly turning a corner in Dover. It's called a casketing area, but where the remains are uniformed and walking into that room and there's 30 young Marines. It's overwhelming to think of the tragedy and loss that had occurred in these 18, 19-year-old young men, but seeing them all in their uniforms, I'm going to cry again. That's probably the one moment where you realize that, man, there's a lot of tragedy that we get to see. Most of it is easily compartmentalized because you turn on the anatomy and science function. But at the scenes and dealing with families, it becomes like I just did, you swallow it down and move on.

Those begin to weigh on you as those stories become heavy, realizing that all of us are potentially in that realm.

Meaning we're all mortal. We're going to die at some point. It's the how and the when that nobody can really answer for sure. The cases that embody the unpredictability of death are usually random crimes, unforeseen or unprepared for events. An example we've all come to know too well, mass shootings. A term the city of Dayton, Ohio, itself knows intimately.

It's overwhelming. Investigators say there are several videos showing the crowds out enjoying a night on the town, reacting to the first shots fired in the area.

Today, we got new.

Information about the massive firepower the shooter.

Brought to.

The scene. He killed nine people before Dayton officers were able to engage him and take him down before he could enter the bar.

On Sunday, August fourth, 2019, just after one o'clock in the morning, a 24-year-old man named Connor Betz started shooting into crowds outside of bars and food stands in the Oregon district of Dayton, Ohio. According to law enforcement's official timeline, reported by CNN, Betz had been out at bars with his younger sister, Megan, for two hours before going to his car, changing his clothes, putting on body armor, loading more than 100 rounds of ammunition, and arming himself with a 223 high capacity rifle. Without reason and without remorse, Betz began shooting randomly down the main street and killing people. According to CNN's reporting, he fired 41 shots in less than 30 seconds and killed nine people, including his 22-year-old sister, Megan. Less than a minute into his rampage, Dayton police subdued Betz and killed him during a takedown. The carnage Connor Betz left in his wake was Kent Hershbarger's job to sort through.

I got the call probably 2:30 in the morning, so I immediately responded to the office. At my office here in Dayton, Ohio, we have nine investigators, so there's usually one on. He was already on the scene. The supervisor was already on the scene of investigations. My role really became at that moment, trying to plan. Well, first of all, is to make sure my staff is safe and then planning how we're going to respond to this as an office. What equipment do we need? What support services do we need from a upper level administrative perspective? Do we need our mobile refrigeration units? Those kinds of things. And it was decided that we could process without. So then I went to the scene, actually, to help pick up the remains. It's a lot of times, we're trying to take it out from the scene.

By 2019, Kent had the unfortunate experience of working several mass casualty incidents in his career. He knew exactly what to do in order to begin processing all of the bodies at once, including the shooters. But before doing anything, Kent remembers he took a long, hard look down Fifth Street in the city he calls home and paused.

It's just, wow. Anybody could have been standing right here when this happened. It was just the turn of luck or tide or God, whatever you decide that people weren't down there or they were down there. But when you see that scene where up and down the street is evidence markers, just the amount of ammunition that was deployed at the scene and then the mark and the remains still in the scene, it's a burnt memory. It becomes overwhelming to think, and again, we've already talked about it, but the realizing the fear, realizing the pain, realizing the helplessness, perhaps in the moment of what was going on.

The most challenging part of processing the date and shooting scene was the fact that law enforcement's firearm ammunition had happen to be intermixed with the shooters. This is a situation that pathologists commonly run into with these kinds of chaotic death scenes.

My job was to help law enforcement put the pieces of what happened back together. It's just our role is around in and on the body. We're documenting shell casings, documenting wound pathways as where they were positioned, those things at the scene. The shooter was known and the weapon was known, but we're still trying to, from a medical perspective, put the pieces, the events back together along with law enforcement. So our role is in around the body, and then law enforcement takes the bigger crime scene. So my investigators and I was there are really documenting where they are, the position they are, what shell casings are around them, for instance, is we're going to have to determine range of fire. So now we have law enforcement who also has the same caliber of weapon as the shooter. So now it becomes all those things we're doing, what wounds belong to the what the ones belong to law enforcement.

So literally picking up shell casings, matching which bullets created what holes in a person who just minutes before was alive. That's the reality Kent faced on the Dayton scene. It's the reality all pathologists face on mass shooting scenes, and it's dark work. Kent says conducting autopsies on mass shooting victims, even as terrible as it is, the process allows him to sharpen his knowledge of how firearms impact human anatomy.

Well, first of all, it's a missile. So the bullet travels through and it creates that area of defect. But what is not understood maybe by the public is what also happens is energy is released by that moving missile. And it's called kinetic energy, but it creates what's known as a temporary cavity. So the faster it's moving, the more power is released, the bigger the temporary cavity. Particularly with a high velocity round like the 223, the AR-15, the kinetic energy formula is mass times velocity squared. So it's delivering energy squared times the faster the bullets going. So the faster, the higher power weapons, the bigger cartridge gives more of an explosion, more power. It's going faster. And so not only where the bullet passes through the body is damaged, but several inches away can be damaged. So you can go through an upper lung, but really damage the aorta just by that temporary because so much energy has been delivered by that round.

Kent has an oddly intellectual way of describing horrifying injuries, but I get it. The more he learns, the better he can ensure that every deceased person who comes through his office with a gunshot wound is getting the most thorough autopsy report possible. That includes the shooter, which think about that for a second. Kent has to treat the autopsy for the Connor Betz of the world the same as his victims. According to Fox 19 news, some of those people who died in Dayton included, Lois Oglesby, Derek Fudge, Logan Turner, Thomas McNickles, Monica Brickhouse, and of course, Megan Betz.

One of the things I don't think public may appreciate as much, we still, as the jurisdiction, have the shooter, and that creates problems with the family. So if you look at the Pulse nightclub shooting, the shooter was placed in a different room. Still, the corner's office, medical examiner's office in Florida, has to take care of it. We have to take care of everybody, which includes the shooter. But that can be very traumatic for families thinking that their loved one is next door to the person that caused the death. So we really try to separate the processes so that families of the victims can have some peace away from the shooter that were the person that caused this pain while they're being processed in the same building.

Perhaps even darker than that, though, is when Kent encounters something in an autopsy he's never seen before, something that's been engineered to inflict a sadistic damage.

There's some really scary things on the market now that have come out. One is called an RIP round. But basically, it divides into seven little tiny rounds once it hits the body and goes off into different pathways, which- Have you seen those? I have seen it in Dayton once, and I've seen it in Indianapolis a few times. What do.

You think when you see that?

First of all, I think it's very scary for me because they'll become very sharp and they're very hard to find inside the body cavity, so you can risk. I generally wear one protective glove so I don't cut myself, but I put another one on my other, on my right-hand, because they're very dangerous for recovering those particles. And when I talk to surgeons, our trauma people that go in to recover them, they need to be aware of those rounds because they're sharp edges that can cut you. But I also think the damage, but somebody's buying that on purpose to be more lethal.

That's a pretty terrifying thought. But bad people with bad intentions, using guns in bad ways, is just where we are as a society, at least in America. From talking with Kent, one thing that is clear to me is that firearms, whether discharged purposely or accidentally, leave apparent and recognizable trauma on the human body. In a gunshot wound case, he can typically rule on the cause and manner of death easily, but some cases aren't so clear. It's those cases, the ones where a pathologist's findings are supposed to be the final say, but not everyone is convinced that really get my mind spinning. That's what I wanted to ask Kent a series of questions on next. Because the amount of trust and reliance the criminal justice system has on one medical examiner or coroner's word is often criticized as being unbalanced. And what's caught in the middle of that imbalance is someone's freedom.

There's also now a lot of pressure, not only pressure from my opinion being evaluated, but there's pressure to make sure I'm right because someone's going to jail.

On every person's death certificate, there are lines for cause of death and manner of death. A forensic pathologist fills in those fields based on their interpretation of a victim's body after conducting an autopsy and studying their injuries and tissues. For example, if it's clear to Kent Hershbarger that someone was stabbed to death or shot from a distance and doesn't have gun powder residue on their hands, odds are high that he'll rule their manner of death a homicide. If there are chemicals or medications in someone's postmortem blood work that are not supposed to be there, then he could rule that death a murder, by poisoning, or maybe accidental overdose. If a person is otherwise healthy with no visible external or internal trauma, but maybe can't found signs that their heart was really unhealthy, he'll more than likely rule that as a natural death, a heart attack, for example. You get at that point. The manner of death label suggests with high probability that someone's passing was either a result of natural causes, a homicide, a suicide, an accident, or it's undetermined, which basically means there's not enough information for Kent to determine a cause of death one way or the other.

The autopsy really starts just like your examination with any physician. When you go to your doctor, you ask, What's wrong? Our history has to come from the scene, or law enforcement or family members. But that's how it all starts, just like any medical examination with a history. We have to know what environment or what circumstances we're dealing with to guide the examination. Most of the examinations are routine in the sense that it's done the same way every time.

So if the process is so straightforward most of the time, then where could there be a problem? Well, as anyone who listens to any true crime podcast will know, all opinions, especially when it comes to criminal cases, are up for debate, including a medical examiner's findings.

That's part of being a forensic pathologist, is you know full well there's going to be another forensic pathologist on the other side, and I call it exploiting the shades of gray. Ultimately, this is a medical science. It's not one plus one equals two. There is room to theorize differently. There is always scrutiny from another medical professional trying to develop the scene. But there's also now a lot of pressure because you're actually the one saying this happened. There's not only pressure from my opinion being evaluated, but there's pressure to make sure I'm right because someone's going to jail. Our ultimate punishment in this society is jail time, potentially the death penalty. And we're the ones that that decision is based on. So that is probably more pressure. I feel more pressure to make sure if I'm going to say it, I'm saying it because I believe it to my core and I can prove it versus just being wishy-washy and that we'll have the jury figure it out. If I'm going to call it a homicide and put somebody on trial for that, it's because I believe it is.

Can you think of a homicide where it was your job to do the autopsy and you either discovered that it was a homicide or you knew in a short amount of time, This is a murder. This is not a natural thing.

We really get into that where it's alleged suicides. So typically a story will be a boyfriend, or she was going to commit suicide, or heand I gallantly was fighting for the weapon, and it went off. And so a lot of those cases become really based on the pathology. What was the range of fire? How close was the weapon? Is the position possible? Is the arm long enough to reach the trigger? Those things. If anything, that's probably more of my investigative point where I feel like I've solved or declared that is a homicide because a gunshot wound is a gunshot wound. When the law enforcement officer can't say, Well, the gun's too far away, many experienced officers know what I'm going to say, but it's really up to us to make that decision and decide this was a homicide. There's no way it could have been done with that story. And that's most of what… We're not trying to impart. We're not trying to create theories of what happened. Our job is to say whether the story makes sense or not with the science.

Sense and science — two fairly reliable things to hang your hat on if you're a forensic pathologist. I like Kent's approach. If he's going to call murder, murder, then that's because he's done the work to back up his findings. If he truly believes a death was not a murder, then he's going to say that and be able to explain intelligently why it's more than likely not a homicide. He's not there to appease law enforcement and put people away without due process. However, he'll be the first to tell you that the forensic pathology profession isn't absent of people who operate that way.

Unfortunately, that happens more common than people think, where I tell people and I teach that part of my job is to put the brakes on law enforcement sometimes because they, and I'm not being critical, but you get involved in the inside of investigation, and my job is not to support their theory. My job is to, is it possible or not? And then go back to the drawing board and we try not to come up with theories. And so a lot of times I do feel like, particularly in baby death investigations, that theories become developed very rapidly, and I can't or can not support it or I can support it, but I feel like a lot of times I'm not supporting it and have pressure back against me. I think that's been some problems across the nation, to be frank, where some of the forensic pathologists have let that pressure dictate a little. Again, it's the same thing of pushing out a theory versus saying what I have matches a theory. Creating theories out of the pathology was not… We should never be doing that. It's really confirming a position, not making the position.

Undermining the system to simply get a prosecution is not what should happen, ever. I mean, think about it. If pathologists and police were in cahoots in every murder case, where would there be room for justice? There wouldn't be. Kent says a forensic pathologist who only cares about being right or going unchallenged shouldn't be in this line of work. A person should only be in the profession if they genuinely care about people, families, and finding the answers to medical mysteries that help everyone understand the processes of death better.

50 % of our work are young, healthy people. Young, meaning mid-40s, who die suddenly of a heart condition or a stroke, something that they weren't aware of. It's a very rare case to do the homicide. It's a lesser percentage than people think most of the television dramas, what people think about our job is really driving from murder to murder, and that's relatively rare. Most of it is young, healthy people who die or accidents with some trauma, or unfortunately, now it's overdoses. Overdoses are by far, are probably highest category. What makes the profession fun to me is being able to solve those mysteries, and particularly in a young, healthy person, being able to give the family an answer. One thing that's unique now, as I said, we've been doing the same procedure for 200 years, but we're adding new tools, and one of those is DNA analysis. There's labs coming on board now to look for cardiac arrhythmia on a genetic basis. And we've had seven or eight cases recently where the answer is in the DNA. There's some pathology, heart's too large or the myocardium, the heart wall is too thick. But actually being able to tell the family of a genetic risk and get them genetic counseling is really gratifying to another tool in our profession.

Kent will never get to have a traditional doctor patient relationship with the people who come through his office, but he's come to terms with that. He finds satisfaction in being able to inform the living with what he's learned from the dead.

It is a different pathway being a physician. Some people will joke, You don't have really any patience, but I do get to be people's physicians. It's just in a different sense. Many of us want to be physicians to have that caring relationship, have that personal contact. And ours has to be created with families and with people we serve or the public, knowing that you're helping a greater good. People need to realize it's really about the living. A lot of people say we talk for the dead and those things, but we're really trying to help all of us as a species to get better and understand disease processes.

According to Kent, knowing what to do when dealing with the dead is the easy part. Forensic pathologists, the great ones, have better skills when dealing with the living. A sensitive, caring disposition can't be taught no matter how many accolades you earn.

It's amazing the degree of compassion, empathy that while we have learned as death investigators to compartmentalize, it's amazing to watch the skill at a scene and dealing with the family and supporting the family through the tragedy that I think comes from somewhere else. You can't be trained. People find the field, and it's a real gift to be able to be compassionate, even in the light of having to do a death investigation. Treat loved ones as they should be as I treat them, everyone as if they were mine.

Leaving our interview, I never felt so comforted by a doctor's parting words, especially a doctor who doesn't operate on anyone that's alive. As I headed back to my car, I gave a lot of thought to the phrase I started my morning with. I feel like I'm dying. Yeah, that definitely was not in the realm of being true. This episode of Dark Areas was written and produced by Delia D'Ambra, with writing assistant from executive producer, Ashley Floars. You can find pictures and source material for this episode on our website, darkarenas. Com. Dark Arenas is an audio Chuck original show. So what do you think, Chuck? Do you approve?